Access to Emergency Contraception After Removal of Age Restrictions

dc.contributor.authorWilkinson, Tracey A.
dc.contributor.authorClark, Porsche
dc.contributor.authorRafie, Sally
dc.contributor.authorCarroll, Aaron E.
dc.contributor.authorMiller, Elizabeth
dc.contributor.departmentPediatrics, School of Medicineen_US
dc.date.accessioned2019-05-21T17:42:26Z
dc.date.available2019-05-21T17:42:26Z
dc.date.issued2017-07
dc.description.abstractBACKGROUND: Levonorgestrel emergency contraception (EC) is safe and effective for postcoital pregnancy prevention. Starting in 2013, the US Food and Drug Administration removed age restrictions, enabling EC to be sold over the counter to all consumers. We sought to compare the availability and access for female adolescents with the 2012 study, using the same study design. METHODS: Female mystery callers posing as 17-year-old adolescents in need of EC used standardized scripts to telephone 979 pharmacies in 5 US cities. Using 2015 estimated census data and the federal poverty level, we characterized income levels of pharmacy neighborhoods. RESULTS: Of 979 pharmacies, 827 (83%) indicated that EC was available. This proportion did not vary by pharmacy neighborhood income level, nor was significantly different from the 2012 study (P = .78). When examining access, 8.3% of the pharmacies reported it was impossible to obtain EC under any circumstances, which occurred more often in low-income neighborhoods (10.3% vs 6.3%, adjusted odds ratio 1.5; 95% confidence interval 1.20-1.94). This was not significantly different from 2012 (P = .66). Correct information regarding over-the-counter access was conveyed only 51.6% of the time; accuracy did not differ by pharmacy's neighborhood income (47.9% vs 55.3%, adjusted odds ratio 0.89; 95% confidence interval 0.71-1.11) and was not significantly different from 2012 (P = .37). CONCLUSIONS: A majority of pharmacies have EC available; however, barriers to and disparities in access for adolescents persist and have not changed since the previous study despite regulatory changes that were designed to improve access to EC.en_US
dc.eprint.versionFinal published versionen_US
dc.identifier.citationWilkinson, T. A., Clark, P., Rafie, S., Carroll, A. E., & Miller, E. (2017). Access to Emergency Contraception After Removal of Age Restrictions. Pediatrics, 140(1), e20164262. doi:10.1542/peds.2016-4262en_US
dc.identifier.urihttps://hdl.handle.net/1805/19408
dc.language.isoen_USen_US
dc.publisherAmerican Academy of Pediatricsen_US
dc.relation.isversionof10.1542/peds.2016-4262en_US
dc.relation.journalPediatricsen_US
dc.rightsPublisher Policyen_US
dc.sourcePMCen_US
dc.subjectAdolescenten_US
dc.subjectAge Factorsen_US
dc.subjectContraception, Postcoitalen_US
dc.subjectHealth Services Accessibilityen_US
dc.subjectSocial Control, Formalen_US
dc.subjectUnited Statesen_US
dc.titleAccess to Emergency Contraception After Removal of Age Restrictionsen_US
dc.typeArticleen_US
ul.alternative.fulltexthttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5495529/en_US
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